... ROCHESTER Minn. Feb. 6 -- Liver transpla...In the United States the United Network for Organ Sharing (UNOS)over...A patient's MELD score is calculated from the results of threelaborat... Early referral to a liver transplant center no longer provides anadv...

ROCHESTER, Minn., Feb. 6 /PRNewswire-USNewswire/ -- Liver transplant is
a life saving treatment option for people with end-stage liver disease.
Unfortunately, the need for donor livers far exceeds the supply. Each year
only about one-third of people who need a donor liver will receive one, and
some patients die while waiting. In the February issue of Mayo Clinic
Proceedings, physicians explore how the current system for allocating donor
organs in the United States affects outcomes for patients with end-stage
liver disease.

In the United States, the United Network for Organ Sharing (UNOS)
oversees the allocation of donor organs. With the goal of giving available
donor organs to the most critically-ill transplant candidates, UNOS adopted
a scoring system called the Model for End-Stage Liver Disease (MELD) in
February 2002. Unlike past evaluation systems, the MELD score de-emphasizes
the length of time a patient has been waiting for a donor organ.

A patient's MELD score is calculated from the results of three
laboratory tests. Scores range between 6 and 40, with higher numbers
reflecting a more urgent need for transplantation. Research has shown that
although the donor liver shortage persists, implementing this allocation
system has decreased the number of patients who die while waiting for donor
organs.

"Early referral to a liver transplant center no longer provides an
advantage for organ allocation. However, it is unclear whether it offers
other advantages, or if alternative strategies should be developed
regarding timing of referral for liver transplant," writes Jaime
Aranda-Michel, M.D., a member of the Mayo Clinic Jacksonville liver
transplant team and lead researcher for a Mayo study on this topic.

The Mayo study examined the evaluation practices and denial and
acceptance criteria for liver transplant used by the Mayo Clinic
Jacksonville Transplant Center after the MELD system was implemented.

"Obtaining a clearer understanding of these issues could result in
changes in the approach to referrals for liver transplant," writes Dr.
Aranda-Michel.

Mayo researchers examined medical records from 555 patients referred
for liver transplant at Mayo Clinic Jacksonville Transplant Center from
Jan. 1 through Dec. 31, 2005. A transplant selection committee typically
determines patient eligibility for liver transplant using a variety of
criteria, including a patient's MELD score. From these 555 patients, 260
were accepted for liver transplant at their first review, and 295 (53
percent) were denied. Among those denied for transplant, 150 (51 percent)
were considered too early for liver transplant while the rest were excluded
due to other medical conditions and psychosocial issues that affected their
eligibility. Patients seeking referral for liver transplant often undergo
repeated assessments by selection committees, as their eligibility can
change over time or following treatment and/or changes in conditions that
led to their initial exclusion.

Significance of the findings

According to Dr. Aranda-Michel, the data from the Mayo study suggest
that even though the current donor organ allocation system favors the most
critically-ill patients, a broad range of patients could benefit from early
referral for liver transplant evaluation.

"Our study suggests that early referral for liver transplant evaluation
offers other advantages unrelated to the time patients spend on the liver
transplant waiting list. If patients too early for liver transplant were
evaluated but not listed, a liver transplant center could initiate
management of end-stage liver disease and address psychosocial issues in a
subgroup of patients who could also ultimately benefit from liver
transplant. Early referral could also lead to the earlier detection and
treatment of liver cancer tumors called hepatocellular carcinomas that
accompany some forms of chronic liver disease. If these tumors become too
large, they can make a patient ineligible for transplant," says Dr.
Aranda-Michel.

In an editorial that follows, author Gennaro Selvaggi, M.D., from Miami
Transplant Institute at the University of Miami, agrees that while the MELD
system has proven to be valuable, those who are responsible for placing
patients on transplant lists face many challenges.

"One could argue that keeping a long list of active patients with low
MELD scores could burden the system. However, many patients can experience
a sudden decompensation of their liver disease, which would rapidly
increase their MELD score," writes Dr. Selvaggi.

"In the end, the most important concept advanced by Aranda-Michel is
that patients should be referred early and followed up by a team of liver
transplant specialists," writes Dr. Selvaggi.

A peer-review journal, Mayo Clinic Proceedings publishes original
articles, reviews and editorials dealing with clinical and laboratory
medicine, clinical research, basic science research and clinical
epidemiology. Mayo Clinic Proceedings is published monthly by Mayo
Foundation for Medical Education and Research as part of its commitment to
the medical education of physicians. The journal has been published for
more than 80 years and has a circulation of 130,000 nationally and
internationally. Articles are available online at
http://www.mayoclinicproceedings.com.

(Date:10/11/2017)... 2017 True Health, a leader in integrated ... during National Breast Cancer Awareness month to educate ... Research recently published ... more than 10 million American women are at ... or BRCA2 and have not had testing. These mutations ...

(Date:10/7/2017)... , Oct. 6, 2017 Provista, ... more than $100 billion in purchasing power, today announced ... and information. The Newsroom is the online ... industry trends, infographics, expert bios, news releases, slideshows and ... access to a wealth of resources at their fingertips, ...

(Date:10/13/2017)... Pa. (PRWEB) , ... October 13, 2017 , ... While ... dark poses a problem. Fortunately, an inventor from Austin, Texas, has identified a solution. ... to medication in darkness or restricted lighting. As such, it eliminates the need to ...

(Date:10/13/2017)... ... ... Talented host, actor Rob Lowe, is introducing a segment ... of "Success Files," which is an award-winning educational program broadcasted on PBS Member ... with passion and integrity. , Sciatica occurs when the sciatic nerve in the ...